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Active vs. Inactive SPMS: What to Know
If you haven’t had any relapses lately — or your MRIs have shown no signs of inflammation — then you likely have inactive SPMS. Research suggests that about 73 percent of people with SPMS have the inactive form, which may also be referred to as “non-active” or “non-relapsing” SPMS.
Despite the name, inactive SPMS doesn’t mean the disease isn’t progressing. Because SPMS worsens over time, it’s possible that people with inactive SPMS may experience more trouble functioning in the future, even if they’re no longer having relapses.
Unfortunately, there are few treatment options for inactive SPMS. “Our [traditional disease-modifying] treatments are really good at dealing with inflammation and relapses,” says Kimbrough. “But [with inactive SPMS] … where, essentially, there’s damage that accrues over time, very slowly, that’s a little bit trickier to treat.”
That said, a class of drugs called Bruton’s tyrosine kinase (BTK) inhibitors look promising in clinical trials. One in particular, tolebrutinib, has been shown to help slow the progression of inactive SPMS. And more BTK inhibitors are actively being studied as potential treatments for this form of SPMS.
Other treatment approaches for inactive SPMS focus primarily on rehabilitation strategies, such as:
- Occupational therapy, to help improve your ability to do daily tasks and show you how to use assistive devices
- Physical therapy, to help improve mobility and walking
- Speech therapy, to help improve your ability to communicate properly and address issues with eating or swallowing
Whether you’re taking medication or not, “It’s very important to have a robust rehabilitation program,” says Kimbrough. “That way, you can preserve the function you still have and maintain more mobility to do the things you need to do.”
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